Is the recent increase in bipolar depression diagnosis driven by drugs currently used for bipolar patients?
The availability of novel therapeutic mechanisms always leads to increased awareness of the possibility that a patient is bipolar. This happened in Europe during the 1950s and 1960s when lithium first became available. The very same thing happened in the United States during the early 1970s. Likewise, the diagnosis of schizophrenia increased when antipsychotics first became available in the US. When safer SSRIs came around, antidepressant-use increased, and family practitioners were trained to recognize depression because they were better able to treat it. Having said that, one should consider bipolar disorder when an antidepressant is not working, especially when it seems to be making the circumstances worse. Each patient with unipolar depression has a measurable risk for bipolarity on a stepwise factor scale. People can have either a low or a high chance of becoming bipolar. Screening for potential heritable risk factors like early age of onset, hypersomnolence, and hyperphagia both
